Alcohol use and cardiovascular disease preventive services

Background: Moderate drinking is associated with decreased cardiovascular mortality. Biological effects may mediate this association, but differences in utilization of preventive services may be important. Design and Methods: Cross-sectional analysis of adults participating in the Third National Health and Nutrition Examination Survey with data on alcohol use and prior use of services for the detection and treatment of hypertension and hypercholesterolaemia. Regression models were analysed to provide age-, sex- and race-adjusted risk estimates for outcomes related to these services for several patterns of alcohol use relative to regular light drinkers. Results: Hypertension was more common in most alcohol use strata compared with regular light drinkers (adjusted prevalence ratios 1.22 for lifelong abstainers, 1.33 for nonlifelong abstainers, 1.35 for infrequent moderate drinkers, 2.01 for frequent moderate drinkers, 1.73 for infrequent heavy drinkers and 1.98 for regular heavy drinkers, P-values < 0.05). Having had blood pressure measured was similar in all drinking strata. The prevalence of hypercholesterolaemia was similar in drinking strata, but most drinking patterns were associated with lower use of services to detect high cholesterol (prevalence ratios 0.7 for lifelong abstainers, 0.8 for nonlifelong abstainers, infrequent moderate and regular moderate drinkers, 0.6 for infrequent heavy drinkers, and 0.7 for regular heavy drinkers, P-values < 0.05). Conclusions: The utilization of cardiovascular disease preventive services may contribute to the beneficial association of moderate drinking with cardiovascular mortality. Additional research is needed to estimate the influence of differences in health services utilization on the association of alcohol use with cardiovascular disease outcomes.